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To address the nursing shortage, it is imperative that healthcare organizations understand the reasons for nurse turnover and develop programs to retain high quality nurses. A program that has been utilized by healthcare organizations is mentoring. Mentor programs have been found to improve job satisfaction thus improving nurse retention. In addition to focusing on orientation programs for new graduate nurses, mentorship programs can be utilized to assist with experienced nurse retention. The purpose of this evidence-based practice project was to pilot a three-month mentorship program with registered nurses with one to three years of experience.
"Practice based on evidence can decrease the uncertainty that patients and clinicians experience in a complex and ever changing healthcare system (Melnyk & Fineout-Overholt, 2005). Evidence-based practice supports and informs clinical, administrative, and educational decision making, considers internal and external influences on practice, encourages critical thinking in the application of evidence to care of the individual patient, patient population, or system and uses the latest research evidence to produce high quality care (Newhouse, Dearholt, Poe, Pugh, & White, 2007). The purpose of this evidence-based practice change project is to blend the mentorship program with the new graduate nurse's orientation program to help reduce the stress of the novice nurse during the transition period and to determine the impact of mentoring of the novice nurse on retention which may directly impact the quality of care and safety of patients in the clinical setting and improve patient satisfaction. Mentoring is practiced in many professions and in many different ways. A mentoring relationship is one in which two individuals grow and develop respect for each other's knowledge level, abilities and capabilities. The relationship may last for an indefinite period of time. Also invaluable experiences and values may be gained and shared in the relationship. The literature provides evidence that the mentoring process for new graduate nurses can provide professional supports to ease the transition from student nurse to practicing nurse and improve retention rates (Halfer, Graf, & Sullivan, 2008) thereby improving patient care which may directly impact patient satisfaction. Background The nursing shortage is no new subject and will continue to escalate to crisis proportions as baby boomers leave the profession to retirement and/or nurses leave the profession to non-nursing related jobs due to dissatisfaction with their nursing role. Also surveys have indicated that registered nurses (RN's and Chief Nursing Officers believe the nursing shortage has negatively affected the quality and safety of patient care (Buerhaus, Donelan, Ulrich, Norman, & Dittus, 2006) which also impacts patient satisfaction in the clinical setting. The United States nursing shortage is expected to grow to over 250,000 registered nurses by the year 2025 (AACN Fact Sheet, 2009). Additionally, nationwide nurse turnover rates are at an all time high ranging approximately 55% to 61% and 35% to 69% of new graduate nurses leave their respected place of employment within the first year (Persaud, 2008). Also the cost of replacing one registered nurse can range anywhere from $30,000 to $145,000 depending on the geographic location and/or specialty area (Block, Claffey, Korow, & McCaffey, 2005). " ... " -- from Overview.
Low retention rates, especially of newly licensed registered nurses (NLRN), translates to a significant financial burden to medical centers due to costs associated with training the new nurse. The nursing leadership at a large community medical center that is currently experiencing an upward trend in turnover rates aims to increase the retention of newly licensed registered nurses through a formal mentorship program. To assess and validate mentorship program needs, the EL-MSN CNL team focused this quality improvement project on conducting a literature review and needs assessment that included key informant interviews, a general survey for registered nurses, and a focus group. A total of nine nursing leadership staff from the medical center participated in the key informant interviews, 141 registered nurses from the medical center completed the general survey, and three registered nurses that had participated in the New Graduate Training Program participated in the focus group. Results from the needs assessment validated the need for a formal mentorship program at this medical center, with over 90 percent of all survey participants stating that mentorship was important or very important in their nursing practice. Additionally, over 50 percent of survey participants would be willing to mentor a NLRN on their specific unit. The needs assessment also informed concrete recommendations to develop a formalized mentorship program that meets the needs of the medical center. The recommendations include introducing a culture of mentorship, integrating the formal mentorship program with the clinical ladder progression, and incentivizing participation. The evaluation plan of the formalized mentorship program includes two surveys that will serve a dual purpose to evaluate the New Graduate Training Program and formal mentorship program. A third survey that will evaluate participant satisfaction with the formal mentorship program. In addition to assessing and validating the needs for a formal mentorship program at this medical center, this quality improvement project highlights areas of potential impact of mentorship on promoting professional development and engagement of the newly licensed registered nurse, increasing nursing competence, addressing lateral violence, increasing retention rates, and increasing job satisfaction.
Newly hired nurses to critical care units need time and guidance to develop the confidence and knowledgeable experience to recognize and instinctually intervene in these moments. Regardless of being a new graduate or just new to the hospital or unit, adapting to the unfamiliarity or physical newness of these microsystems adds to the difficulty with all the new processes and policies, monitoring equipment as well as any other foreign equipment used within the microsystem. Many newly hired registered nurses report a disconnect in these intense and fast paced settings leading to a lack of professional confidence (Ortiz, 2015). Research shows to varying degrees, 35% - 60% of newly hired nurses will leave their first place of employment within a year of their hire date (Flinkman, Isopahkala-Bouret & SalanteraÌ8, 2013). Frequently, newer nurses report feeling unwelcomed or underprepared, frustrated, and bullied in their new microsystems (Hawkins, Jeong & Smith, 2019). At a local community hospital, turnover rates are increasing enough that executive leadership has dubbed the issue a "revolving door" problem of nurses being hired but leaving shortly after. . It was discovered that mentoring programs have been utilized to help new nurses develop confidence, gain insight into their health care systems, and develop quality nursing skills; mentoring also has increased job satisfaction and retention, benefiting not only the health organization, but also the patients these nurses care for (Hodgson and Scanlan, 2013). A mentorship program was proposed to this community hospital's stakeholders, and permission was granted to implement a program and measure its results.
The purpose of this project is to help increase retention of newly licensed registered nurses (NLRN) at a large community medical center. The medical center loses approximately 20 NLRNs per year which is costly for the medical center. The loss of NLRN can be attributed to decreased job satisfaction, poor nursing competence and lateral violence between the nursing staff. Evidence shows that mentorship is a proven, evidence-based approach to solving these issues and more (Hodgson & Scanlan, 2013). Not only can mentorship help increase retention, address lateral violence, increase job satisfaction and nursing competence but, it can also help enhance NLRN nurses0́9 professional and personal growth. A mentor can help guide the mentee into becoming more involved in the community medical center as well as promote professional development by encouraging the mentee into achieving higher levels of education and reaching for loftier career goals. The emotional support provided by the mentor helps to increase the confidence of the NLRN by bridging the gaps between preceptorship and patient care. Literature shows that mentorship creates more unity within the unit thus increasing nursing competence which then leads to increased patient care (Jewell, 2013). The large medical center is interested in all of these factors and thus requested a formalized, standard, evidence-based nurse mentorship program to be implemented on all floors of the hospital. The Entry-level MSN CNL (EL-MSN CNL) student team conducted a quality improvement project to address these needs by developing a formalized mentorship program for newly licensed registered nurses at a large community medical center.
The first two years of employment within an organization are identified as a crucial period for establishing oneself in practice, becoming part of an organization, and continuing employment. Use of mentoring programs in nursing has led to higher reported satisfaction, with increased retention rates. Globally, there is a gap between the supply of healthcare professionals and demand for these services. Nationally, there is also a shortage of healthcare professionals, while it is projected that the elderly population will experience the largest growth inthe next eight years, further exacerbating the workforce shortage. Currently, there is a lack of mentoring programs for nurses in a psychiatric hospital located in North Texas. This facility had experienced tremendous nursing staff turnover. Implementation of a pilot mentoring program for nurses employed at the hospital was undertaken to address the high nursing turnover rate. The objective of this project was to improve job satisfaction and increase a sense of community and belonging amongst nurses by way of a mentoring program. The Model for Evidence-Based Practice (EBP) Change framework was used to guide this capstone project of incorporating a mentoring program amongst nurses employed at the psychiatric hospital. Theoretical models used in this project included Lewins' Stages of Planned Change, Herzberg's Theory of Motivation, the Learner-Centered Mentoring Model and Knowles Adult Learning Principles. A mentoring toolkit was used to initiate the mentoring program at the hospital. the mentoring program took place over eight weeks, using three teams of mentor-mentees. Job satisfaction scores did improve, but not by more than 50%as projected. Qualitative evaluations revealed that participants desired the mentoring program to continue. All mentees recommended their mentor as future mentors. One participant expressed interest in leading the mentoring program past the project. Future mentoring will incorporate more participants and will occur over a timeframe of six months to one year. The literature suggests mentoring is a cost effective way to retain new and seasoned nurses; high quality mentoring can be effective in organizations that are time and resource limited. Research shows that mentoring is a support structure for nursing personnel and can function as a means to increase nurse job satisfaction. While the retention of nurses was beyond the scope of this pilot, there was statistically reliable improvement in nurse job satisfaction after implementing this mentoring program. Several tools utilized in this project can be broadly applied in nurse mentoring to quantify outcomes. This project could help to reduce nurse turnover rates in the psychiatric hospital by improving job satisfaction.
The shortage of nurses in the United States is astounding, the retention of the experienced nurses is one of the reasons for the shortage, with an increase of retention, and the shortage problem may decrease. A decrease in nursing retention has been a constant problem on the progressive care unit (PCU) in the acute care setting. Many nurses are starting their career on the PCU and find that the support and resources are lacking. The purpose of this proposed project is to implement a mentor program for the new hire/graduate nurses to help them achieve success, and make the PCU their forever home. The author will discuss the implementation, the process, the evaluation, and how to disseminate the information about the program to the stakeholders. Information was gathered for this topic by researching articles, discussion with fellow employees and the retention issue with the managerial team. Based on the research and discussions done by the author a mentor program would benefit job satisfaction along with increase numbers in retention rates.
The purpose of this integrative review is to identify commonalties of mentor program success demonstrated by registered nurse retention to support DNP leaders seeking to address the nursing shortage by retaining newly licensed and experienced registered nurses. Mentor programs offer nurse leaders a low-cost solution with a high return on investment to address nurse retention. The United States is facing a tremendous nursing shortage compounded by multiple factors, including an unprecedented global pandemic. An aging population is leaving the profession while the new generation of nurses struggle to find their niche. Registered nurses make up the largest sector of health care workers. Retaining newly licensed nurses is essential to the future of health care and the nursing profession. Nurse leaders need proven solutions that are easily identifiable to tackle the monumental nursing shortage on the horizon.
Previous research suggests that mentoring benefits Student Registered Nurse Anesthetists (SRNAs) in many ways including decreasing stress levels and increasing academic retention rates. There is little research, however, that explores the mentoring structure preferred by SRNAs. To answer this question, the researchers surveyed 387 student members of the American Association of Nurse Anesthetists (AANA) and analyzed the results using descriptive statistics, Chi-square testing, and Straus and Glaser’s Grounded Theory. Researchers found that SRNAs prefer a mix of formal and informal mentoring and a layered approach to mentoring consisting of both a recently graduated CRNA and near-peer SRNA mentor. The study also found it was important to SRNAs that a mentor share a similar personality with them, be able to provide clinical and career guidance, and be able to facilitate networking. In addition, the survey data suggests that there are periods in an academic anesthesia program where mentorship is essential, including at the beginning of the program and before clinical rotations begin. Perhaps the most crucial finding was that non-Caucasian students often have different perspectives towards mentoring than Caucasian students. This was the most profound demographic difference found by this study, influencing responses more than any other demographic characteristic including age, sex, or relationship status. Future research is needed to investigate the different needs of minority SRNAs to ensure mentorship programs are structured in such a way to meet the needs of SRNAs.
With mentorship being a key to addressing several issues at a large community medical center, the leadership of the institution engaged with students of a Clinical Nurse Leader (CNL) Program to conduct a thorough assessment. This paper addresses the charge for a standardized and formalized evidence-based approach to a nurse mentorship program to address key areas that enhance not only the work environment but also the quality of care. These key areas include the 1) promotion of professional development and engagement via 2) acquisition of skills necessary to achieve nursing competence, 3) address lateral violence, 4) increase in staff retention rates and 5) increase in job satisfaction. A systematic needs assessment was conducted, along with a literature review, to inform a recommendation for the development of a formalized mentorship program that would coincide with an already in place new grad residency program for newly licensed registered nurses (NLRN) at the large community medical center. The root cause analysis indicated that individuals that were hired into the new grad residency left their position within twelve months at a significant rate. As such, the outcomes of the literature review and needs assessment indicated that a formalized mentorship structure would help not only with creating a more healthy work environment but also create significant cost savings for the institution. While the program was not implemented at the institution, evaluation tools are proposed for the appropriate ongoing assessment and growth of the quality improvement project.